studies of bathing and toileting was that hospital-
ized patients had a significantly lower oxygen con-
sumption during these activities than did healthy
subjects. Patients moved more slowly and deliber-
ately than did the healthy subjects. Consistent with
Levine’s (1973, p. 7) notion that we “reduce activity
to that which is absolutely necessary,” patients seem
to reduce activity on their own to promote healing.
Levine (1989) later stated that:
The conservation of energy is clearly evident in the
very sick, whose lethargy, withdrawal, and self-
concern are manifested while, in its wisdom, the body
is spending its energy resource on the processes of
healing. (p. 332)Many of the studies using the Conservation
Model as the basis for the investigation are single
studies or are the beginnings of research program
development. There is no replication and little con-
sistency in how the variables are measured. The re-
sults of the studies are therefore not sufficient to
change nursing practice but they do cluster in two
areas that, with continued study, could have a
major influence on how nurses practice.
In general, the studies support that energy can
be conserved with nursing interventions and can be
measured through the assessment of organismic re-
sponses. Patients inherently conserve their own
energy when confronted with environmental chal-
lenges. The second important finding is that atten-
tion to the conservation principles explains the
organismic response of confusion (delirium) better
than does any single principle alone. This supports
the assumption that using the conservation princi-
ples to guide interventions will promote adaptation
and maintain wholeness.
Investigators are encouraged to continue their
excellent work with Levine’s model. New investiga-
tors are encouraged to consider the Conservation
Model as a basis for study and to test the proposi-
tions developed from the theories discussed later in
this chapter. It is only with continued research that
a scientific basis for nursing will be developed.
USE OF THE CONSERVATION MODEL
IN THE TWENTY-FIRST CENTURY
Nurses of the future will continue to build on the
basic principles of nursing established by Florence
Nightingale (1859). Nightingale was a visionary
woman who knew that nurses should be prepared
professionals in institutions of higher education.
Levine continued in this tradition and focused a
great deal of her professional career on preparing
advanced practice nurses as clinical nurse special-
ists. Levine’s Conservation Model and the theories
developed from the model provide a basis for the
future of professional nursing. The model includes
a method for assessment; identification of prob-
lems; development of a hypothesis about the prob-
lem; the identification, selection, and application of
an intervention; and an evaluation of the response.
The interventions are provided based on the as-
sumption that if the intervention attends to the
conservation of energy, structural, personal and so-
cial integrities, the patient will return to wholeness
(health). Health is a goal for individuals, families,
communities, and populations at large. From a
global perspective, “health for all” is an appropriate
metaphor. Wholeness is universally understood.
The model includes three major concepts that are
critical to understanding the health-care delivery
systems of the future: adaptation, wholism
(health), and conservation (balance of energy sup-
ply and demand within the capabilities of the pa-
tient [organization, community, and universe]).The model includes three major concepts
that are critical to understanding the
health-care delivery systems of the future:
adaptation, wholism (health), and conser-
vation (balance of energy supply and de-
mand within the capabilities of the patient
[organization, community, and universe]).The Conservation Model provides the concep-
tual basis for the development of three theories: the
theory of conservation, the theory of redun-
dancy, and the theory of therapeutic intention.
About theory, Levine said:- “The serious study of any discipline requires a
theoretical baseline which gives it substance and
meaning” (1969a, p. xi). - “The essential science concepts develop the ra-
tionale [for nursing actions], using ideas from
all areas of knowledge that contribute to the
development of the nursing process in the spe-
cific area of the model” (cited in Fawcett, 1995,
p. 136).
CHAPTER 9 Myra Levine’s Conservation Model and Its Applications 105